CSB cuts mental health services in Hampton, NN

The Hampton-Newport News Community Services Board will see an almost $6.5 million decrease in its 2014 operating budget, a cut of just over 10 percent from this year.

The Community Services Board provides comprehensive mental health and substance abuse services for residents of Hampton and Newport News, as well as services for those with intellectual and developmental disabilities. Last year it served more than 15,500 individuals. A reduction in its services will start to take effect July 1.

One casualty is the Lassen House Psycho-Social Day Treatment Program in Hampton that has a 17-person staff and serves 120 clients, according to a May 31 memo to city government from CSB executive director Charles A. "Chuck" Hall. In it he described the CSB as having "experienced more financial challenges this past fiscal year than at any time in our 42-year history."

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In the memo, Hall attributed the financial challenges to conversion to electronic health records and "ongoing changes in Medicaid service definitions, billing codes, reimbursement rates and pre-authorization processes." The HNNCSB earns the majority of its revenue from Medicaid reimbursement. "Medicaid is doing everything they can to control spending," said Hall. Before 2010, the CSB was able to make a little margin from Medicaid clients, who account for about two-thirds of its caseload, to cover the provision of medical care to the indigent, he said.

Federal cost-cutting policies, the downsizing of Eastern State Hospital, the rapid growth in the number of those seeking services — an addition of almost 2,000 in the past year — and the increasing number of clients without a payer source, have all combined to create the budget crunch, Hall said.

The cities of Hampton and Newport News are slated to chip in $3,214,183, or less than 6 percent of the CSB's recommended FY14 operating budget of $63,198,054. "Of all the urban CSBs, there's a compelling argument that we have very low per capita funding," said Hall. "If each locality gave us $1 million more we would then have the local support that would more closely mirror others."

However, he does not blame the localities, conceding that the initial CSB model was designed not to use local taxpayer dollars and noting that his January budget submission came late in the cities' budget development process. Hall is optimistic that the situation will provide the necessary stimulus for the cities and the CSB to develop a more logical funding formula for the medically indigent in the following budget year.

Meanwhile, other changes for FY14 outlined in Hall's memo to city government, include:

• Ending the IDD (intellectual disabilities) voucher program which has sponsored individuals at The Arc and Eggleston in Hampton, affecting 36 people;

• Leaving one full-time adult psychiatrist position vacant — their current caseloads average around 500 enrolled patients;

• Establishing waiting lists for the first time for almost all services, including outpatient therapy, medication management, and day support;

• Attempting to negotiate a reduced staff presence at the Hampton City Jail, the Newport News City Jail and the Newport News City Farm Jail, potentially affecting four full-time staff;

• Changing the contracts for therapeutic day treatment counselors assigned to schools, approximately 130 staff will go from 12-month contracts to 10.5 month contracts;

• Eliminating 65 full-time positions, 35 of which have incumbents;

• Cancelling leases on apartments that provide housing to individuals with either mental illness or substance use disorders, primarily at Liberty Estates in Hampton.